Lynchburg plastic surgeon Dr. Sam Fuller was volunteering with Operation Smile in Africa when a young nurse approached him with a request. He and his team had just finished surgery on all the children with cleft palates and lips that they could schedule this visit and had told the remaining 150 families they would have to come back next year. The nurse informed him that there was a young boy who had traveled a long way to see him. It had taken one full day for the 9-year-old and his mother to walk to the bus station. After a 12-hour bus ride, they walked another four hours to get to the Operation Smile site.

“They want to wait for you,” she said. Fuller, who went out to reiterate that he couldn’t put the boy on the surgery schedule this time, saw the boy flash a big smile. “This is my son Joseph. You fixed his lip last year, and he wanted to come back to show you how handsome he is,” the mom said.

“I felt about one inch high,” Fuller says of his hesitance to see the boy. “An experience like this puts you in your place, and you discover the place you are meant to be is right here. This is not about you. It’s about the kids. It makes you think this is somebody tapping you on the shoulder to say ‘this is important.’”

Fuller, now retired and living in Richmond, is one of over 5,000 medical volunteers from more than 80 countries who offer their time and talents to Operation Smile. There are 138 medical volunteers in total from Virginia from a range of specialties, including plastic surgeons, anesthesiologists, nurses, pediatricians, pediatric intensivists, dentists, speech therapists, nutritionists and child life specialists.

The Virginia Beach-based organization provides free reconstructive surgery for children and young adults worldwide who suffer from facial deformities such as cleft lips and cleft palates. Since its founding in 1982, it has provided free surgeries for more than 200,000 children and young adults and performed more than 3.5 million health care evaluations. The organization, which is celebrating its 30th anniversary this year, currently has programs and foundations in more than 60 countries.

Norfolk pediatric plastic surgeon William P. Magee Jr., M.D. and D.D.S., and his wife, Kathleen, a registered nurse, founded the organization after participating in a medical mission trip to the Philippines sponsored by a nonprofit called Philplast in 1982. “I had gone through all this training and wanted to take care of kids with facial deformities,” Dr. Magee says. “An opportunity came up to go with a group of plastic surgeons and their wives from Texas to the Philippines.”

The Magees, both New Jersey natives, had settled in Norfolk when Bill accepted his first position after residency with Plastic Surgery Specialists Inc. in 1978. Dr. Magee received his D.D.S. from the University of Maryland and his M.D. from George Washington University Medical School, and served his general surgery residency at the University of Virginia Medical School. The Magees stayed in the area and raised their five children. “It was a stretch to take off for two weeks,” he says, adding the couple took their oldest daughter, Bridgett, 13, with them on the first mission. “It changed our lives and our value in life.”

What the couple witnessed in the Philippines was overwhelming. There were hundreds of children with deformities waiting to be served. “It was a unique experience,” says Kathy. “Everywhere we turned, there was a sea of deformities. People pushed their babies at us, tugged at our sleeves with tears in their eyes and begged us to help their children. We had never been exposed to anything like this.”

The turnout wasn’t uncommon in an undeveloped country where medical care is scarce. “It’s a huge problem,” says Dr. Magee, 68, who notes that every three minutes a child is born with a cleft palate or cleft lip. “One out of every 10 kids will die before their first birthday; one out of 12 before their fifth birthday.”

The team in the Phillippines ended up treating about 40 children out of the approximately 250 families that had gathered. The Magees felt both touched and guilty, says Kathy, 67. “We said to ourselves, ‘Why don’t we get some friends and go back and take care of those kids?’ Operation Smile was born in our hearts. It was that emotional moment that led to its creation.”

Building the organization wouldn’t have been possible without the help of the Hampton Roads community, she adds. “When we asked for help from business people they said, ‘Absolutely, we will help you.’”

And they weren’t the only people to step up. All of the Magees’ children have been involved with the organization in some way, and now their grandchildren are going on mission trips.

After returning home from that first visit to the Philippines, their daughter Bridgett asked a friend to help her form a student club at Norfolk Academy to fundraise for the organization. Today Operation Smile Student Clubs has 900 clubs and associations around the world, in everything from elementary schools to medical schools. They raise an estimated $1 million annually for the organization, and at least two high school students from the clubs accompany each of Operation Smile’s international mission teams.

The organization also hosts the annual International Student Leadership Conference, where student volunteers from 20 countries learn leadership and character development. “All of this grew out of kids helping kids,” says Kathy.

While medical volunteers from the U.S. like Dr. Fuller still travel to partner countries to treat children, the majority of surgeries are performed by skilled medical volunteers who live and work in that country or region. “What began as an idea to help only a few children has grown into a network of volunteers and medical missions transforming thousands of lives,” says Dr. Magee, noting that the organization’s 35 in-country foundations help partner countries sustain their own medical programs.

Dr. Ruben Ayala, senior vice president of International Programs and Medical Affairs, oversees all international operations. He was barely 17 when he started volunteering as a translator for the organization in his home country of Panama. “Walking in the hospital and seeing hundreds of children and their families waiting for care is something I have never forgotten. I had never seen a child with a cleft. It was almost endless. I was in shock and dismay. I never imagined so much sadness and misery would be in one location,” he says. “That day will stay with me the rest of my life.”

That experience is what ultimately led Dr. Ayala to pursue a medical career and to eventually join the staff of Operation Smile. In 1997, he went back to Panama to witness the first medical program done entirely by Panamanians. “I could see their joy and their pride,” he says. “Panama was one of the first countries to become sustainable.”

In order to create sustainability in each partner country, Operation Smile has to set up training, create a local entity and form partnerships with local hospitals, other non-governmental organizations (NGOs) and sponsors. “People might think our model is based on projects where we take volunteers to another country,” explains 39-year-old Ayala, “but 66 percent of our programs are local programs.”

The organization adheres to its strict Global Standards of Care in every partner country. The standards ensure that all patients benefit from the same procedures and credentialed medical staff no matter where they receive care around the world. “We brought in the top medical leaders from the countries we are in to help us create the principles we live by,” Ayala says.

Operation Smile also operates more than 20 Comprehensive Care and Training & Treatment Centers around the world. These medical facilities offer year-round patient care including surgery, post-operative care, speech therapy and nutrition. The most state-of-the-art center is in Guwahati, India, where Dr. Fuller served as the center’s chief medical director. (He lived in India for six months in 2012.) The center has taken care of approximately 10,000 patients. “It had been in operation for about six to eight months before I got there, and they had the most up-to-date equipment I had worked with,” he says. “Everyone there is a full-time employee, and everyone is good at what they do. It’s a well-oiled machine.”

One of the organization’s areas of expansion is Africa where they partner with Smile Train for Rwanda Smiles. Currently Rwanda has only one trained plastic surgeon. “We are working with other NGOs to bring in people who have basic medical training and bring them up to the level of work we need,” says Ayala.

Sharon Neece, a 56-year-old neonatal intensive care unit nurse at Riverside Regional Medical Center in Newport News, serves on the Operation Smile Nursing Council, helping to recruit and credential new pre- and post-operative nurses. She started volunteering with the organization in 1999 and has been on more than 28 missions. On her first mission, she flew to the Philippines. The reality of the situation was staggering, she says. “We had over 300 prospective patients show up. It seemed like a million people to me. Unfortunately, we had to select only 120 patients.”

She found it hard to turn people away. “Tears flowed from those who couldn’t be helped that day and from the volunteers,” she says, adding that surgery days start around 7 a.m. and go until 9 p.m. “Anywhere from 25 to 30 surgeries are done a day. It is so busy during the day that you hardly have time to think about how tired you are.” She will often not eat until after 10 p.m., and be up again in the morning ready to go at 5 a.m.

Even though the job can be difficult, the mother of two grown children wouldn’t give up her time volunteering. “I use my vacation, lose pay for two weeks, and the travel is often grueling,” she says. “But I get back so much more than I give. Operation Smile has changed my life and my family’s life in so many positive ways that it is difficult to describe.”

The organization will move into its new $20 million, 72,300-square-foot global headquarters in the Princess Anne Commons area of Virginia Beach later this year. The high-tech headquarters building will serve as a training and conference center and will feature the “best information technology systems possible,” says Dr. Magee, who serves as the organization’s executive chairman and works with Operation Smile every day. Dr. Magee also maintains a private practice in Norfolk and is director of The Institute for Craniofacial and Plastic Surgery in the Children’s Hospital of The King’s Daughters. The new building will help bring awareness to the problem of clefts and focus on the work that the organization is doing around the world.

Dr. Fuller has served on more than 25 medical missions since he started volunteering with the organization in 1988. “Operation Smile is very addictive,” he says. “It gives you more than you give to it.”

Each surgery is a “miracle that is getting ready to happen,” he adds. “It’s not a miracle I did. It’s one I get to participate in. We are all part of it.” OperationSmile.org